Individual
HOMER ALLEN RICHARDSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D
Contact information
Practice address
2701 NORTH DECATUR ROAD, DECATUR, GA 30033
(404) 501-1849
Mailing address
2100 POWELL STREET, EMERYVILLE, CA 94608-1803
(510) 350-2777
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
49993
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000799022
BCBS-BAPTIST
—
05
—
7100224220
—
KY
01
—
P01209417
MEDICARE RAILROAD
KY
Enumeration date
05/11/2006
Last updated
10/25/2013
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